Hong Eng Goh, B'Sc' Hons',

1
Forensic Neuropsychology and the
MMPI-2Development of aStructural Summary
Approach to the Assessment of Personal
Injury Claimants
Hong Eng Goh, B.Sc. (Hons)., Graeme J. Senior,
Ph.D., University of Southern Queensland,
Toowoomba, Queensland, Australia gohh_at_usq.edu.au
senior_at_usq.edu.au
INTRODUCTION The MMPI-2 is the most popular
measure of psychosocial functioning in assessing
personal injury claimants in the medicolegal
setting (Ben-Porath, Graham, Hall, Hirschman,
Zaragoza, 1995). Despite a huge research
literature (more than 10000 publications since
the MMPI was developed), little has changed in
terms of the interpretive approaches and
strategies utilised with this measure. For
example, use of the codetype interpretative
approach, where profiles are classified according
to the two or three most elevated clinical
scales, is still in widespread use. Another
approach has been developed by Archer and
Krishnamurthy (1994) for the MMPI-A. This
utilises the factor structure to organise
clusters of scales to form a simpler method of
interpretation called the Structural Summary.
The objective of the current study was to
generate a Structural Summary approach for the
MMPI-2 based upon a factor structure that is
sensitive to personal injury claimants. Such an
approach could potentially increase the
reliability of the derived measures as well as
resolve some of the difficulties with the high
level of redundancy and item overlap intrinsic to
the MMPI-2. This will result in a substantial
reduction in the complexity of the information
from the MMPI-2 into a smaller set of clinically
meaningful and setting specific components.
PARTICIPANTS An initial sample of 3300
MMPI-2 protocols was examined from forensic
psychological practices in the USA (N1,407 ) and
Brisbane (N1552) as well as a normative sample
from the University of Southern Queensland
(N341). Diagnostic groups included TBI
(10.5) adjustment disorder (10) pain disorder
(10) somatisation disorder (8.6) depression
(6.8) PTSD (5.8) substance abuse (3.9)
medical conditions (3.2) anxiety disorder
(3.1) malingerers and those with inadequate
motivation (2.8) personality disorders (2)
learning disabilities (1.4) panic disorder
(1.2) and other diagnoses (7.8) no diagnoses
or diagnoses not available (11.8) normals
(11.1) Protocols were excluded from the study
if they had cannot say(?) raw score gt 10 VRIN
T-score or TRIN T-score gt80. Final number of
protocols - 2,838 Mean Age 35.9 (SD
13.8) Mean Education 11.8 (SD 4.2)
Gender Male (49) Female (51) MEASURES 75
scales and subscales L, K, F, Hs, D1, D2, D3,
D4, D5, Hy1, Hy2, Hy3, Hy4, Hy5, Pd1, Pd2,
Pd3, Pd4, Pd5, Mf, Pa1, Pa2, Pa3, Pt, Sc1,
Sc2, Sc3, Sc4, Sc5, Sc6, Ma1, Ma2, Ma3, Ma4,
Si1, Si2, Si3, ANX, FRS1, FRS2, OBS, DEP1,
DEP2, DEP3, DEP4, HEA1, HEA2, HEA3, BIZ1, BIZ2,
ANG1, ANG2, CYN1, CYN2, ASP1, ASP2, TPA1,
TPA2, LSE1, LSE2, SOD1, SOD2, FAM1, FAM2, WRK,
TRT1, TRT2, A, R, Es, MAC-R, DO, Re, APS, AAS
RESULTS Principal Component Analysis with
oblique rotation was conducted on the 2,838
protocols Ten components were retained with
eigenvalues of greater than 1 Total amount of
variance accounted by the ten components
approximately 75 (41.01,11.96, 5.35,
3.35, 3.03, 2.66, 2.4, 1.82, 1.61,
1.41)
RESULTS (continued)
While ten components were derived, only eight
reflect meaningful reductions in the complexity
of the MMPI-2. Component 9 was not
computed as it has essentially only one scale
loading (all 8 items on the Si2 scale occur
on the 16-item SOD1 scale). So the component
is represented by SOD1 alone. Component 10
is unlabelled. Implications of the
relationship between gender identity and
fears for psychopathology are unknown nor its
implications for personal injury claimants.

Table 1 Components of the Structural
Summary Component 1 General Maladjustment
(a0.98)
1. DEP1 - Lack of drive 2. Sc4 - LEM,
conative 3. D5 - Brooding 4. DEP2 -
Dysphoria 5. Sc2 - Emotional alienation 6.
TRT1 - Low motivation 7. D1 - Subjective
depression 8. D4 - Mental dullness 9. DEP4 -
Suicidal ideation 10. Pd5 - Self alienation 11.
Pt Psychasthenia
12. LSE1 - Self doubt 13. DEP3 - Self
deprecation 14. ANX - Anxiety 15. A - Anxiety 16.
Hy3 - Lassitude-Malaise 17. WRK - Work
interference 18. Pd4 - Social alienation 19. D2
Psychomotor retardation 20. Sc3 -
LEM, cognitive 21. Pa2 Poignancy
USING THE COMPONENTS OF THE STRUCTURAL SUMMARY
To convert the weighted composite raw score to
a linear T-Score component mean is
component variance is composite raw
score is converted to a standard score and
then transformed to a linear T-score A
cut-off of T65 is used as an indication of
elevation of the component.
ILLUSTRATIVE CASE EXAMPLE 27 year-old male
with 12 years of education diagnosed with
Post-Traumatic Stress Disorder
Elevations are indicated in components 1, 3,
5, 6, 7, and 9 indicating clinically
significant endorsement of general
maladjustment, social vulnerability and
discomfort, and somatic complaints and
psychotic symptoms. He reports being
restricted or constrained by his
circumstances. Examination of the elevations
of scales that comprise each component will
permit a more fine-tuned determination of
his reported difficulties.
REFERENCES Archer, R. P., Krishnamurthy, R.
(1994). A structural summary approach to the
MMPI-A Development and empirical correlates.
Journal of Personality Assessment, 63,
554-573 Ben-Porath, Y. S., Graham, J. R., Hall,
G. C. N., Hirschman, R. D., Zaragoza, M. S.
(1995). Forensic applications of the MMPI-2.
Thousand Oaks, CA Sage
Component 10 Unlabelled (a0.68)
1. FRS2 Multiple fears
2. Mf Masculinity femininity