Use of the MMPI-2 personality disorder scales in the assessment of DSM-IV antisocial, borderline, and narcissistic personality disorders

This study explored the diagnostic utility of the MMPI-2 Personality Disorder (MMPI-2 PD) scales to correctly classify three Cluster B Personality Disorders (Antisocial, Borderline, and Narcissistic Personality Disorder). Classification was compared against the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) chart diagnoses checked for interrater agreement. MMPI-2 PD scale scores for 53 outpatients diagnosed with a Cluster B Personality Disorder were contrasted with an Other Personality Disorder group (n = 20) and a nonclinical population (n = 67). Scores for both the overlapping and nonoverlapping scales of the MMPI-2 PD scales were used in calculating diagnostic efficiency statistics. In support of past findings, results suggest the MMPI-2 PD scales should be used conservatively; they are best at screening for presence or absence of a personality disorder, identifying members of personality disorder clusters, and identifying negative occurrences of specific personality disorders or personality disorder clusters. Findings endorse the use of both versions of the Antisocial Personality Disorder scale and the overlapping version of the Borderline Personality Disorder scale. Use of the Narcissistic Personality Disorder scales is recommended for negative predictive power values only. A multimodal approach is recommended, whereby assessment measures may be used conjointly to improve diagnostic efficiency.