New Directions inInterpreting theMillon Clinical

Multiaxial Inventory-III(MCMI-III)

Edited by

Robert J. Craig

John Wiley & Sons, Inc.

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New Directions inInterpreting theMillon Clinical

Multiaxial Inventory-III(MCMI-III)

New Directions inInterpreting theMillon Clinical

Multiaxial Inventory-III(MCMI-III)

Edited by

Robert J. Craig

John Wiley & Sons, Inc.

This book is printed on acid-free paper.

Copyright 2005 by John Wiley & Sons, Inc. All rights reserved.

MCMI-III and Millon are trademarks of DICANDRIEN, Inc. MCMI-III copyright 1977,1982, 1983, 1987, 1994 DICANDRIEN, Inc. All right reserved. Published and distributedexclusively by Pearson Assessments.

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Rorschach is a registered trademark of Verlag Hans Hube, AG, Bern, Switzerland.

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Library of Congress Cataloging-in-Publication Data:

New directions in interpreting the million clinical multiaxial : inventory-III (MCMI-III) /edited by Robert J. Craig.

p. cm.Includes bibliographical references.ISBN 0-471-69190-9 (cloth)1. Millon Clinical Multiaxial Inventory. I. Craig, Robert J., 1941

RC473.M47N49 2005616.89075dc22

2004059092

Printed in the United States of America.10 9 8 7 6 5 4 3 2 1

www.wiley.com

Contents

Contributors vii

Introduction ix

Part I New Directions in MCMI Interpretation

1 The MCMI-III Facet Subscales 3Seth D. Grossman and Cristian del Rio

2 Diagnosing Personality Disorder Subtypes withthe MCMI-III 32Roger D. Davis and Michael J. Patterson

3 Alternative Interpretations for the Histrionic, Narcissistic,and Compulsive Personality Disorder Scales of the MCMI-III 71Robert J. Craig

4 Combined Use of the PACL and MCMI-III to AssessNormal Range Personality Styles 94Stephen Strack

5 Issues in the Assessment of Personality Disorders andSubstance Abusers with the MCMI 129Patrick M. Flynn

6 International Uses of the MCMI: Does Interpretation Change? 144Gina Rossi and Hedwig Sloore

Part II Newer Applications with the MCMI-III

7 Using the MCMI-III for Treatment Planning and to EnhanceClinical Efficacy 165Jeffrey J. Magnavita

8 Use of the MCMI-III with Other Personality Inventories 185Robert J. Craig

v

9 Forensic Application of the MCMI-III in Light ofCurrent Controversies 201Frank J. Dyer

Part III Continuing Controversies

10 Assessing Response Bias with the MCMI Modifying Indices 227R. Michael Bagby and Margarita B. Marshall

11 Validity of the MCMI-III in the Description andDiagnosis of Psychopathology 248Andrew G. Ryder and Scott Wetzler

12 The Diagnostic Efficiency of the MCMI-III in theDetection of Axis I Disorders 272Paul Gibeau and James Choca

13 On the Decline of MCMI-Based Research 284Robert J. Craig and Ronald E. Olson

14 Using Critiques of the MCMI to Improve MCMIResearch and Interpretations 290Louis Hsu

Appendix A: Diagnoses Associated with MCMI Code Types 321

Appendix B: Millon Clinical Multiaxial Inventory Bibliography 357

About the Editor 403

Author Index 405

Subject Index 413

vi CONTENTS

R. Michael Bagby, PhDUniversity of TorontoToronto, Ontario, Canada

James Choca, PhDRoosevelt UniversityChicago, Illinois

Robert J. Craig, PhD, ABPPJesse Brown VA Medical CenterChicago, Illinois

Roger D. Davis, PhDDigonex Technologies, Inc.Miami, Florida

Cristian del Rio, PhDCarlos Albizu UniversityMiami, Florida

Frank J. Dyer, PhDPrivate PracticeMontclair, New Jersey

Patrick M. Flynn, PhDInstitute of Behavioral ResearchTexas Christian UniversityFort Worth, Texas

Paul Gibeau, PsyDArgosy UniversityChicago, Illinois

Seth D. Grossman, PsyDInstitute for Advanced Studies

in Personology andPsychopathology, FloridaInternational University

Miami, Florida

Louis Hsu, PhDFairleigh Dickinson UniversityTeaneck, New Jersey

Jeffrey J. Magnavita, PhD,ABPP, FAPA

Hartford HospitalUniversity of HartfordGlastonbury, Connecticut

Margarita B. Marshall, PhDUniversity of TorontoToronto, Ontario, Canada

Ronald E. Olson, PhDOakland UniversityRochester, Michigan

Michael J. Patterson, PhDDigonex TechnologyMiami, Florida

Gina Rossi, PhDVrije Universiteit BrusselsBrussels, Belgium

vii

Contributors

Andrew G. Ryder, PhDConcordia UniversityMontral, QC, Canada

Hedwig Sloore, PhDVrije Universiteit BrusselsBrussels, Belgium

Stephen Strack, PhDU.S. Department of Veterans

Affairs Ambulatory Care CenterLos Angeles, California

Scott Wetzler, PhDAlbert Einstein College of

Medicine Montefiore MedicalCenter

Bronx, New York

viii CONTRIBUTORS

Introduction

THE MILLON Clinical Multiaxial Inventory (as revised)III (MCMI-III) has become a mainstay in clinical assessment and is used in a multi-plicity of settings and for a variety of assessment and treatment planningpurposes. Research cited throughout this book documents its frequent usein clinical, counseling, medical, and forensic services in both public andprivate practice venues. Only the MMPI and the Rorschach have enjoyedsuch widespread application.

Clinicians value this test because of its clinical utility. And yet, sciencedoes not stand still. New discoveries, new conceptualizations, new re-search, and critical analysis continue to refine the way we assess and theway we frame these assessments. The same is true for personality assess-ment in general and for the MCMI-III in particular. Millon continues torefine his bioevolutionary model, on which the test is based, and his pro-totype personality disorders have evolved toward greater specificity withthe theorized personality disorder subtypes. With the introduction of thethird edition of the MCMI, researchers are determining how well this lat-est revision compares with its MCMI predecessors, as well as evaluatingthe test in light of some continuing controversies. Much of this new way ofthinking about and understanding the MCMI are presented in this book.Contemporary research issues relating to the MCMI are also discussed.

This book is divided into three main sections. Part I addresses somenew directions in interpreting the MCMI. Part II highlights some newerapplications of the MCMI-III. Finally, Part III addresses some of the con-tinuing controversies with the MCMI-III. The critical analyses on whichthese chapters are based actually appeared in relation to the MCMI-I and-II, and it remains to be seen whether or not these criticisms will remainapplicable to the MCMI-III.

The MCMI is a theory-derived instrument for measuring Millons tax-onomy of personality classification. He initially used a biopsychosocialmodel for his theoretical notions, but this was eventually superseded by abioevoluntionary model that generated, from theory, basic personalitystyles for nonclinical populations as we