Forensic Questions and Answers on the MMPI/MMPI-2. Alex B. Caldwell. Caldwell Report, Los Angeles, CA., 1996, 101 pp., $29.95 (cloth).
Review By Alice F. Chang, Ph.D.
The MMPI and MMPI-2 are not only the most widely used of all objective measures of personality assessment, but they are also consistently the bedrock of forensic assessments and testimony. Ackerman (1997) reported that in a sampling of 201 child custody assessors, the MMPI-2--or occasionally the original MMPI--was included in 91% of all parental assessments done, with lesser frequencies for all other tests used.
Articles on the forensic use of the MMPI and MMPI-2 have consistently started from the view of the court: what does the court need to know from personality assessment and what parts of that need can tests such as the MMPI answer? Starting from the MMPI rather than from the perspective of the court, Caldwell has provided a brief and concise set of answers as to what the MMPI can demonstrate--what questions can be asked of the MMPI and what answers it can provide.
The book is entirely in a question and answer format, the standard question and answer approach of legal discourse. Each chapter poses a series of questions with answers ranging from one paragraph to two or three pages. Caldwell asserts that he wrote the book for attorneys as well as psychologists. The first chapter, "The Test," is correspondingly basic--although his simple-sounding descriptions of the scales could well be used to communicate their meaning to a jury. He uses "MMPI/MMPI-2" to designate the instrument as a whole, regardless of which form is being used.
Caldwell's second chapter on Test-Taking Attitude depends in part on the extra validity scales scored by the Caldwell Report and also utilized in the Structural Summary of Greene and Nichols (but otherwise rarely scored and applied). His effort to sort out conscious distortion from the powerful impact of a person's socioeconomic status (e.g., Caldwell, 1997) is of potentially vital relevance where "He faked it!--He did not!" accusations are thrown back and forth and are hard questions to answer unequivocally.
The emphasis is strongly practical, e.g., the consequences of using one form versus another, the benefits of double-plotting profiles and answering questions about having done so, who can be expected to take it, reading it out loud, taking it home, defending interpretations of profiles in the normal range, etc. Caldwell's formulation of the assessment of the risk of dangerousness is unique and fertile, and it is clearly in contrast to the usual multi-correlational approach. For forensic purposes he proposes three points of focus: the person's threshold for violence, the array of moderator variables that influence the level of risk, and circumstantial elements which he differentiates as "stage setting"--downturns in the person's life--and "immediate triggers" to occasions of violence. This approach deftly separates out for the court what we can predict, e.g., a "walking bomb" versus a severely inhibited person, from what we cannot predict, e.g., future setbacks and situational frustrations in the person's life. It offers a clear presentation to the court as to what are the reasonable capacities of our powers of prediction as contrasted to future circumstances and provocations that can never be predicted. Caldwell offers a parallel analysis as to the prediction of suicide.
The issue of using computer-generated analyses in our clinical reports and testimony has mostly been noted for the struggle to formulate ethical standards and for published aggravations against psychiatric abuses (e.g., Matarazzo, 1983). Following comments on the under- appreciated power of actuarial prediction, Caldwell comes from the other direction, providing a model paradigm for introducing an actuarial report into one's courtroom testimony. The convergence of the clinician's observations with a report based solely on the client's responses (no observer bias) then takes on special objectivity and power.
Particular attention is given to the use of the MMPI/MMPI-2 in child custody assessments, an arena of notably consistent use of the instrument. He provides a review of the research on parenting, an area of perhaps surprisingly limited research. The subsequent discussion of the three pairwise combinations of scales 3-Hy, 4-Pd, and 6-Pa--so remarkably prevalent in prolonged custody battles--is especially illuminating as to the parenting issues that are identified by each of these code types.
The book provides two sets of references, one a set of psychological references and resources (with annotative comments on what one can find in each reference), and the second-- provided by Stuart Greenberg--is a listing of crucial appellate rulings on a variety of questions as to the admissibility and application of MMPI/MMPI-2 data.
A deficiency of the book is its insufficient discussion of the use of the MMPI/MMPI-2 in personal injury litigation. Although the groundwork for using the instrument is presented, a variety of specific issues such as malingering in that context and the interaction of physical injuries and pain with scales such as 1-Hs and 3-Hy needs more development. Perhaps this will be remedied in a future revision.
At 101 pages (and a few are blank to encourage clinicians and attorneys to keep notes on cases relevant to the topics in that chapter), the book is relatively brief. At times one wishes Caldwell had elaborated in more detail. In particular, one might want more citations and detailed discussion of the literature as in a journal article. The benefit, however, is that the content is very concise and to the point of each of the 49 questions posed. As a working manual, between the table of contents and the index, one can easily and quickly look up what he as to say on each issue without wading through unwanted verbiage. I find it hard to imagine an MMPI-wielding forensic psychologist who would not want this book within quick reach.
Ackerman, M. J., & Ackerman, M. C. (1997). Custody evaluation practices: A survey of experienced professionals (Revisited). Professional Psychology: Research and Practice, 28, 137- 145.
Caldwell, A. B. (1997). Whither goest our redoubtable mentor, the MMPI/MMPI-2? Journal of Personality Assessment, 68, 47-68.
Matarazzo, J. D. (1983). Science, 221, 323.