MMPI-2-RF HIGHER ORDER PATHOLOGY OF PHYSICIANS IN DISTRESS

Abstract

Modern theories of psychopathology incorporate a higher-order approach to conceptualization (e.g., Krueger & Tackett, 2003). These theories are often characterized as having internalizing, externalizing, and thought disorder content as critical elements. This higher order approach has recently been incorporated into the MMPI-2-Restructured Form (MMPI-2-RF; Tellegen & Ben-Porath, 2008/2011). Using individual higher-order content scales and instrument wide interpretive schemas, a hierarchical emphasis on interpretation is part of a critical effort to bring the MMPI in line with current conceptualizations of psychopathology. However, there is a paucity of research available about the utility of scale wide interpretive frameworks, despite their use being recommended for interpretation. Using a population of physicians in distress, this study evaluated the potential portability and generalization of the MMPI-2-RF’s interpretive framework into a novel population through structural analysis using several analytic methods (i.e., Confirmatory Factor Analysis, Exploratory Structural Equation Modeling, and Exploratory Factor Analysis). Each of these techniques included different assumptions about scale interrelatedness and broader relationships and, when taken together, provides a comprehensive evaluation of the feasibility of the higher-order themes as an interpretive framework for the MMPI-2-RF in a population of physicians in distress. Although no model was found as entirely appropriate to the proposed framework noted by the authors of the MMPI-2-RF, the three critical areas of psychopathology did emerge. Issues with incorporating these higher order models are related to the need for nested factors, specifically relating to externalization content of anger, hostility, and aggression. Beyond guidance on general interpretability of the higher order themes, specific guidance is offered for use of the MMPI-2-RF in a population of physicians in distress.