Learn the most reliable test for schizophrenia and how it is used. See how I helped my client to give her the right diagnosis.
Many psychiatrists can not determine the diagnosis of a patient. Experts often have a different opinion about it. That’s why it’s important to go to a psychologist and make a psycho-diagnosis.
I will tell you the story of my client and you will understand why psychodiagnostics is important. The client responded to all of the statements in the test and, thanks to this, found a way to heal.
In the following rows you will find out what the “Depression” and “Schizophrenia” scales are, as well as their sub-bases. I will tell you what the results of the girl who visited my office were. PM, 28, told her story and, together with her, solved her problems.
The most reliable test to diagnose schizophrenia (as well as all psychiatric illnesses) is the multifactorial personal questionnaire MMPI-2
The Minnesota Multi-Factor Personal Questionnaire (MMPI) belongs to the group of personality research tests, which are divided into questionnaires.
Created in 1946 in the State of Minnesota by psychologist SR Hathawey and psychiatrist J. McKinley, the test quickly gained the trust of clinicians and psychologists, translated into many languages and found to be widely used both in the original and in the form of abridged variants , adaptations and standardization.
The English / original / name of the questionnaire is the Minnesota Multiphasic Personality Inventory and the inventory of Bulgarian adaptation and standardization includes: a set of statements, registration forms, profile sheets, keys.
Traditionally, translation of the MMPIs is done by a team of translators (Butcher, 1996). It is assumed that a single translation can hardly achieve the required quality and precision, so the process of adaptation and standardization usually starts with several independent translations, which then interpreters discuss in a group until they reach agreement on the best translation of each separate item (statement in the test).
For the Bulgarian adaptation of MMPI, five independent translations were initially prepared by seven different translators (two translations were made by teams of two translators). The translations have taken into account both the linguistic and the conceptual equivalence of the themes. In the case where the two principles contradict each other, priority is given to conceptual proximity.
The seven translators (three of whom professionals, and the other bilingual clinical psychologists) discussed the content of the on-line questionnaire, and the resulting preliminary version of the test was checked in several small pilot studies. Then the questionnaire was translated from English by another translator, a Bulgarian, a clinical psychologist living and working for more than five years in the United States.
The return results showed that about 10% of the numbers still need to be processed. It was made by the authors of the Bulgarian version, and the improved version was translated again by English by another translator, also a Bulgarian, clinical psychologist who has been living and working for more than 10 years in the United States.
This version of the Bulgarian MMPI was sent to the Minnesota University Publishers for approval. There the Bulgarian version was submitted for review in the language center of the university, where are the latest proposals for corrections to the translation. They are accepted and reflected in the questionnaire text, and the Bulgarian translation is approved by the UMP.
The Bulgarian MMPI normative sample consists of 512 men and 501 women, whose demographic characteristics correspond to the structure of the Bulgarian population according to the census data in 2001.
The normative sample includes persons from all regions of the country and it is proportional to the geographical distribution of the Bulgarian population. Despite the efforts, however, the persons with higher education remained oversubscribed in the Bulgarian normative sample (as is also the case in the US), as the high association between education, ethnicity and protocols did not allow a simultaneous balance to be achieved in both demographic indicators.
The representative clinical sample for the Bulgarian version of MMPI is compiled according to a procedure similar to that used in the compilation of the national normative sample.
The clinical sample corresponds to the structure of the Bulgarian population by sex, age / up to 60 years / and ethnic origin, and the Bulgarian population of mentally ill in the frequency of clinical diagnoses.
As in the normative sample, here too, more educated people are over-represented. The reason for this is again the high percentage of invalid test protocols that were obtained among the persons with lower secondary education.
When subjected to a factual analysis, the raw results without K-correction on the three valid scales (L, F and K) and the ten clinical scales of MMPI, four factors are typically extracted: “General Psychopathology”, “Repression” /, “Social Inversion” and “Masculinity-Femininity” (Butcher & Han, 1996).
The discovery of a similar factual structure of the covariance of the same scales from the Bulgarian version of the test can be considered as a testimony to the functional equivalence of the adapted version with the original instrument (Van de Vijver & Poortinga, 1982).
The MMPI questionnaire contains the following and final number of rocks:
- Two Values for Validation / Vrin and Trin /
- Three scales to check the consistency of responses / F, FB, FP /
- Three scales to test the propangled protective attitudes (L, K and S /
- Ten clinical scales (Hs, D, Hy, Pd, MF, Pa, Pt, Sc, Ma and Si /
- Fifteen Content Roles / ANX, FRS, OBS, DEP, HEA, BIZ, ANG, CYN, ASP, TRA, LSE, SOD,
- Twenty-eight Harris and Lingoes / D1, D2, D3, D4, D5, Hy1, Hy2, Hy3, Hy4, Hy5, Pd1, Pd2, Pd3, Pd4, Pd5, Pa1, Pa2, Pa3, Sc1, Sc2, Sc3 , Sc4, Sc5, Sc6, Ma1, Ma2, Ma3, Ma4 /
- Three subscales on Si / Si1, Si2, S3 /
- Sixteen additional scales (Mac-R, APS, AAS, PK, O- H, A, R, Es, Do, Re, Mt,
- Nine restructured clinical rocks / CD, RS1, RC2, RC3, RC4, RC6, RC7, RC8, RC9 /
The full version of the MMPI questionnaire contains 567 statements, of which 85 are critical.
A Bulgarian version of the revised NEO personal questionnaire / NEO PI-R / / Kosta, Makriy and Nikolov, 2007 / was chosen as the main tool for verifying the conceptual validity of the Bulgarian version of MMPI. NEO PI-R is not a clinical test, but it is often used as an aid in the clinic, and the interrelations of its rocks with the MMPI rocks are well known (Costa, Bush, Zonderman & McCrae, 1986). In addition, this tool covers a very wide range of personality traits, which include almost all the well-known personalities of psychology.
The study of correlations between the Bulgarian versions of MMPI and NEO PI-R is based on the results of 141 non-psychiatric subjects, predominantly male (93%) aged 19-24 years, who completed the two tests at a time interval of 3 months and 1 year.
The information on the MMPI questionnaire from the administrative and interpretative guidance is as follows:
- Description of the test
- MMPI-test materials
- Creation and development of the original MMPI
- Re-standardization of MMPI
- MMPI rocks
- Bulgarian adaptation and standardization of MMPI
- Administration and scoring of MMPI
- Interpretation of test results
The information is sufficient, clear and understandable, and it is easy for specialists to learn about the use of the methodology, but in the interpretation of the test results, words such as cynical, egocentric, immature, and others that may be offensive to probands. At the same time, the information is not too complex and well structured.
|Valid and clinical scales||Kronbach alpha||Content rocks||Kronbach alpha||Additional rocks||Kronbach alpha |
|L||0.69 / 0.62 /||ANX||0.83 / 0.89 /||A||0.89 / 0.89 /|
|F||0.70 / 0.64 /||FRS||0.80 / 0.72 /||R||0.52 / 0.67 /|
|FB||0.75 / 0.72 /||DEP||0.81 / 0.85 /||Do||0.34 / 0.74 /|
|F / P /||0.34 NA||HEA||0.79 / 0.76 /||Re||0.56 / 0.67 /|
|S||0.85 NA||BIZ||0.73 / 0.73 /||Mt||0.84 / 0.84 /|
|HS||0.81 / 0.77 /||ANG||0.77 / 0.76 /||PK||0.87 / 0.85 /|
|D||0.58 / 0.59 /||CYN||0.81 / 0.86 /||MDS||0.70 / 0.61 /|
|HY||0.50 / 0.58 /||ASP||0.71 / 0.78 /||Ho||0.83 / 0.87 /|
|PD||0.59 / 0.60 /||TPA||0.67 / 0.72 /||OH||0.25 / 0.34 /|
|MF||0.59 / 0.58 /||LSE||0.80 / 0.79 /||MAC-R||0.35 / 0.56 /|
|PA||0.51 / 0.34 /||SOD||0.81 / 0.83 /||AAS||0.45 / 0.61 /|
|PT||0.88 / 0.85 /||FAM||0.81 / 0.73 /||APS||0.53 / 0.48 /|
|SC||0.87 / 0.85 /||WRK||0.87 / 0.82 /||GM||0.84 / 0.67 /|
|MA||0.61 / 0.58 /||TRT||0.83 / 0.78 /||GF||0.72 / 0.57 /|
|SI||0.83 / 0.82 /||_||_||_||_|
|K||0.73 / 0.74 /||OBS||0.75 / 0.74 /||Es||0.65 / 0.60 /|
- The brackets are given the odds of the Crown Alpha on the rocks of the original version. In a darker font are given rocks whose consistency in the Bulgarian version of MMPI is problematic; In the original test manual there is no data on the reliability of this scale.
- Table 1 presents data on the internal consistency coefficients (Kronbach alpha) of the Bulgarian MMPI form, compared to the same coefficients calculated for the original test scales.
- Table 1: Comparison of coefficients of inner consistency / Crown alpha / on the rocks of the Bulgarian and the original version of MMPI.
My client did not believe her relatives had a mental illness. I administered her Minnesota personal questionnaire and found she had psychotic symptoms, depression and suicidal thoughts. The latter skillfully hide from me. Luckily, I discovered the problems in time when I sent the girl to a psychiatrist.
This was necessary because suicidal thoughts can be realized during psychotherapy and time should not be lost. Scale Schizophrenia is the largest scale in MMPI. The analysis of her questions results in 7 states: paranoia, poor concentration, poor physical health, psychotic tendencies, rejection, confinement, and sexual problems.
The varied content of the articles makes it difficult to analyze the scale. The likelihood of an elevation of the profile is not great. In most cases, a rock appears in combination with some other scale, which greatly facilitates interpretation.
When the result on the scale is very high – on the order of 100 or more points – the client may experience acute loss of personality and personality or acute psychotic reaction but not suffer from schizophrenia. Similar results are sometimes received by young people suffering from acute identity crises. The Schizophrenia Scale has an interpretation of the points as follows:
- Very high (76 points and more) – mental disorder, extrinsic behavior, wrong judgments, social isolation, bad contact with reality, hallucinations, life in one’s own world
- High (66-75) – with unusual beliefs, with strange actions, closed and alienated, against the common, insecure and uncertain identity, with difficulties in conception and thinking
- Moderately tall (56-65) – with a low interest in people, impractical, creative, and imaginative, tense as a string, with religious interests.
- Average (41-55) – responsive, reliable well balanced
- Low (40 and lower) – following the generally accepted norms and conservative, self-controlling, subordinate.
The result of my client on the scale was very high. I examined and nodded, and found that the scale of emotional alienation was also exaggerated. This explains the presence of the psychotic symptoms.
Drops on the Schizophrenia scale are 6 in number. They provide a broader stop to the client’s condition and are an important stage in diagnostics. They are the following:
- Social Alienation – Persons with high values on the subconscious feel misunderstood, unusual, or unjustly punished by others. They believe that their families lack love and support and are hostile to their relatives. They feel lonely, empty and never truly loved. In extreme cases, they can believe that others are trying to physically hurt them.
- Emotional alienation – Subjects with high values are depressed, discouraged, apathetic, believe their situation is hopeless and may have the intention of suicide.
- Lack of Ego Mastery, Cognitive – Subjects with high levels of fear are afraid of losing their minds, share unrealistic experiences and strange thought processes, have problems with concentration of attention and memory.
- Lack of Ego Mastery , Conotative – Faces with high values on the sub-rocket feel life as a huge tension. They are depressed, alarming, have serious difficulties in coping with everyday life, think that their situation is hopeless, that life does not interest them, bring them satisfaction or is not worth living.
- Lack of Ego Mstery, flawed suppression – Lisa with high values on the subwash that they have no control over their emotions and impulses, they are hyperactive, impulsive, easily excitable and unbalanced. They have episodes in which they easily laughed or whimpered and could not be controlled, or those in which they did not realize what they were doing.
- Odd sensory sensations and perceptions – Subjects with high values share delusions of influence and attitude, hallucinations, and thoughts of strange content. They may have had the feeling that their bodies change strangely and unexpectedly, have experienced unusual skin sensations or other strange sensory experiences.
Psychotic V was elevated and found that the patient was suffering from bipolar disorder with wrong judgments.
The Psychotic V profile is one of the most common configurations of rock schizophrenia, psychhaemia and paranoia. At it the rocks paranoia and schizophrenia are over 80 points, and the psychhaemon scale is over 65 points, ie the entire profile is elevated. Customers with a similar configuration are emotionally unresponsive, socially suspicious and hostile, often lacking insight into their behavior, may have delusions, mental disorders and hallucinations.
Most often, they are diagnosed with paranoid schizophrenia, but sometimes such a profile can also be experienced in patients with moody affective disorders (for example, bipolar disorder). Therefore, besides the rocks of “Psychotic V”, we should also look at the client’s clinical cli- mate outcomes.
The depression scale consists of 57 remarks and measures the experience of intense negative emotions, sadness, sadness, guilt, despair, hopelessness, dissatisfaction with status, apathy, lack of interest, reduced physical and sexual activity, physical fatigue, sleep disturbances and eating, hypersensitivity and feeling of loneliness, and lack of social support.
The rock is composed empirically, just like the other rocks. The representative sample included 50 patients with bipolar disorder in the depressive phase. Initially, their results were compared with those of healthy individuals, but the scale was subsequently adjusted to avoid its dysrimitic structure.
All items on the scale are specially selected. So the frequency of abnormalities responds increasingly to the severity of depressive symptoms. The depression scale assesses exogenous or reactive depression rather than endogenous depression.
It measures how well people feel secure and satisfied with themselves and the surrounding world, as well as with some unstable and transient depressive state. Only 13 of 57 artists are unique to this rock, and three of them are repair items included in the scale of the second stage of its construction.
Clients who are in a severely depressive state tend to give answers far beyond the norm than those in a weaker state. The results of various scale-related intelligence tests reveal two factors – “Neuroscience”, to which 28 narratives are grouped, and “Poor somatic health, to which 12 statements belong. The depression scale is mixed. Only 9 of her claims are involved in content MMPI-2 “Depression”.
The raw ball has the following interpretation:
Very tall (76 and higher ) – Closed in itself, overwhelmed with problems, desperate (does not see hope). Watered by wine; with a sense of inferiority and inadequacy. Swallowed by thoughts of death and suicide. Faded with delayed thinking and action.
High (66-75) – secluded, closed, shy. Sad lack of energy, difficult to concentrate. With physical complaints, there are sleep problems. Self-esteem, low self-confidence, feeling inadequate, unhappy. He experiences annoyance, irritation, confused self-confidence; sick mood depression, in which a peculiar combination of sadness, anger, malice, anger, dissatisfaction, irritability stands out, the sick are excitable and aggressive.
Moderately tall (56-65) – Closed, irritable, timid, dull, depressed, moody, gloomy. Dedicated, discouraged, sad and unhappy, dissatisfied with himself and the world. Pessimistic, alarming. Introverted, moralist. Responsible, modest.
Average (41-55) – pleased with himself. Stable, well-balanced, realistic.
Low – (40 and lower) – active, enthusiastic, pleased. Bold, enthusiastic, optimistic. No depression, controlled. Good-natured, self-confident.
My client had a high ball of scale depression as well as subjective depression. It means that the sick person feels unhappy or depressed, lacks energy to cope with everyday problems, and says she has lost interest in what’s happening around her.
Once I administered the test and the client responded to all the claims she visited a psychiatrist who successfully and put the correct diagnosis.
If you liked this article, please support us on Facebook.
- Nikolay Nikolov and team OS Bulgariq – “Administrative and interpretative management of MMPI-2”, 2008
- Konstantin Mechkov – “Medical Psychology”, first edition.