MCMI-III™ (Millon™ Clinical Multiaxial Inventory-III)

Authors: Theodore Millon, PhD, DSc, with Carrie Millon, PhD,
Roger Davis, PhD, and Seth Grossman, PsyD

New facet scales help identify underlying issues.

Based on Dr. Theodore Millon's ground-breaking theory of personality and psychopathology, the MCMI-III (Millon Clinical Multiaxial Inventory-III) assessment provides one of the most well-researched and widely used measures of adult psychopathology available today. Now updated to include the Grossman Facet Scales, this powerful tool has gained even greater strength.

Valued for its brevity, the MCMI-III instrument helps quickly and accurately assess DSM-IV®-related personality disorders and clinical syndromes. A hallmark of this proven instrument is its treatment-oriented Interpretive Report, which presents a an integrated view of results. Mental health professionals around the world have come to rely on the MCMI-III test as indispensable support for personalized therapy that focuses on returning patients to long-term healthy functioning.

How to Use This Test

The MCMI-III test provides valuable support to psychologists and other qualified mental health professionals in clinical, counseling, medical, forensic and other settings in which individuals are being assessed for emotional, behavioral, or interpersonal difficulties. This theoretically grounded instrument can be used to help:

• Assess the interaction of Axis I and Axis II disorders based on the DSM-IV classification system
• Identify the deeper and pervasive personality characteristics underlying a patient's overt symptoms
• Gain an integrated understanding of the relationship between personality characteristics and clinical syndromes to facilitate treatment decisions

Key Features

• NEW! To facilitate more precise therapy planning, three facet scales have been added for each MCMI-III personality scale. The new facet scales were developed by Seth Grossman, PsyD, using factor analytic techniques within the framework of Dr. Millon’s theory. These scales help clinicians pinpoint specific personality processes (e.g., self-image, interpersonal conduct, cognitive style) that are the key elements composing overall elevations on the personality scales.
  
  
• To help clinicians readily put test results to work, the Interpretive Report includes a Treatment Guide that provides short-term, focused treatment options and a Capsule Summary that gives a concise overview of diagnostic and therapeutic findings indicated by test results.
  
  
• Unlike some other measures of personality and psychopathology, the MCMI-III Interpretive Report provides an integrated interpretation of the scales, including a description of the patient's personality characteristics and an assessment of clinical syndromes within the context of those characteritics. The report also proposes a list of possible DSM-IV diagnoses and a profile of base rate scores for all scales.



• Taking only 25 minutes to complete, the MCMI-III instrument is designed to obtain the maximum amount of information with a minimal amount of patient effort. As the need for efficient and accurate differential diagnosis of complex disorders grows, mental health professional have increasingly come to value the MCMI-III test's brevity.

Quick Facts

About the Authors

Theodore Millon, PhD, DSc, was Founding Editor of the Journal of Personality Disorders and Inaugural President of the International Society for the Study of Personality Disorders.  He has held Full Professorial appointments at Harvard Medical School, the University of Illinois, and the University of Miami. Among his professional activities, he is the primary developer of the Millon inventories. A prolific author, Professor Millon has written or edited more than thirty books, including Disorders of Personality, soon to be published in its third edition, and the just published Personalized Clinical Assessment: A Clinician’s Guide to the Millon Inventories. APA and APF have established the Theodore Millon Award for Mid-Career distinguished scholars in personality psychology. With the support of colleagues and Pearson, Professor Millon serves as Dean and Scientific Director of the Institute for Advanced Studies in Personology and Psychopathology.

Carrie Millon, PhD, is Assistant Dean of the Institute for Advanced Studies of Personology and Psychopathology and was instrumental in the conception, development, and validation of the MBMD assessment. She has co-authored several texts in the personality/psychopathology field and has written numerous articles and chapters in the mental and physical health area. Prior to joining the Institute, Dr. Millon was an assistant professor at the University of Miami School of Medicine, Department of Psychiatry and Behavioral Sciences, director of the University‘s Biopsychosocial Center for the Study of AIDS, and director of the University‘s EAP program. She also helped design behavioral programs as a clinician at the University of Miami’s Pain and Rehabilitation Programs in its Department of Neurological Surgery.

Seth Grossman, PsyD, is a research coordinator and practicing psychologist at Florida International University's Counseling and Psychological Services Center, and Senior Consultant of Instructional Programs for the Institute for Advanced Studies in Personology and Psychopathology. His doctoral dissertation laid the groundwork for the theoretically anchored and contextually integrated “Grossman Facet Scales” of the MCMI-III. Dr. Grossman has co-authored over 30 journal articles, book chapters, instruments, and textbooks over the past eight years, and is now frequently lecturing and conducting training workshops on personality assessment and intervention, both nationally and internationally. He recently co-authored an expansion and reworking of Dr. Millon’s therapy model that is reflected in a new three-volume series on "Personalized Therapy" published by Wiley.

Scales

14 Personality Disorder Scales (Coordinate with DSM-IV Axis II disorders)

Moderate Personality Disorder Scales 1 - Schizoid
2A - Avoidant
2B - Depressive
3 - Dependent
4 - Histrionic
5 - Narcissistic
6A - Antisocial
6B - Sadistic (Aggressive)
7 - Compulsive
8A - Negativistic (Passive-Aggressive)
8B - Masochistic (Self-Defeating)

Severe Personality Pathology Scales
S - Schizotypal
C - Borderline
P - Paranoid

10 Clinical Syndrome Scales (Coordinate with DSM-IV Axis I disorders)

Moderate Syndrome Scales
A - Anxiety
H - Somatoform
N - Bipolar: Manic
D - Dysthymia
B - Alcohol Dependence
T - Drug Dependence
R - Post-Traumatic Stress Disorder

Severe Syndrome Scales
SS - Thought Disorder
CC - Major Depression
PP - Delusional Disorder

Correction Scales (Help detect careless, confused or random responding)

Modifying Indices
X - Disclosure
Y - Desirability
Z - Debasement

Validity Index
V - Validity

Clinical Personality Patterns (11) and Corresponding Grossman Facet Scales
1 - Schizoid
1.1 - Temperamentally Apathetic
1.2 - Interpersonally Unengaged
1.3 - Expressively Impassive

2A - Avoidant
2A.1 - Interpersonally Aversive
2A.2 - Alienated Self-Image
2A.3 - Vexatious Representations

2B - Depressive
2B.1 - Temperamentally Woeful
2B.2 - Worthless Self-Image
2B.3 - Cognitively Fatalistic

3 - Dependent
3.1 - Inept Self-Image
3.2 - Interpersonally Submissive
3.3 - Immature Representations

4 - Histrionic
4.1 - Gregarious Self-Image
4.2 - Interpersonally Attention-Seeking
4.3 - Expressively Dramatic

5 - Narcissistic
5.1 - Admirable Self-Image
5.2 - Cognitively Expansive
5.3 - Interpersonally Exploitive

6A - Antisocial
6A.1 - Expressively Impulsive
6A.2 - Acting-Out Mechanism
6A.3 - Interpersonally Irresponsible

6B - Sadistic (Aggressive)
6B.1 - Temperamentally Hostile
6B.2 - Eruptive Organization
6B.3 - Pernicious Representations

7 - Compulsive
7.1 - Cognitively Constricted
7.2 - Interpersonally Respectful
7.3 - Reliable Self-Image

8A - Negativistic (Passive-Aggressive)
8A.1 - Temperamentally Irritable
8A.2 - Expressively Resentful
8A.3 - Discontented Self-Image

8B - Masochistic (Self-Defeating)
8B.1 - Discredited Representations
8B.2 - Cognitively Diffident
8B.3 - Undeserving Self-Image

Severe Personality Pathology (3) and Corresponding Grossman Facet Scales (9)

S - Schizotypal
S.1 - Estranged Self-Image
S.2 - Cognitively Autistic
S.3 - Chaotic Representations

C - Borderline
C.1 - Temperamentally Labile
C.2 - Interpersonally Paradoxical
C.3 - Uncertain Self-Image

P - Paranoid
P.1 - Cognitively Mistrustful
P.2 - Expressively Defensive
P.3 - Projection Mechanism

Norms

The extensive normative sample for the MCMI-III test consists of 998 males and females with a wide variety of diagnoses. This group includes patients seen in independent practices, clinics, mental health centers, forensic settings, residential facilities and hospitals.

The new Corrections report builds on the clinical norms and has norms based on 1,676 male and female inmates.

Report Options

Profile Report (Product Number 51514)
Providing a graphic representation of base rate scores for all scales including the new Grossman Facet Scales, this report can help quickly identify clients who may require more intensive evaluation.

View a sample Profile Report.

Interpretive Report (Product Number 51513)
This report records the patient's demographic information and graphically presents the base rate scores for all scales, including the new Grossman Facet Scales. The integrated interpretation provided by the report includes a description of the patient's personality characteristics, an assessment of clinical syndromes, a listing of possible DSM-IV® diagnoses and treatment recommendations based on individual results. A Capsule Summary is also provided.

View a sample Interpretive Report.

Corrections Report (Product Number 51535)
The Corrections Report includes all of the information in the Interpretive Report, plus two distinguishing features: the use of special correctional norms for certain scales and a one-page summary of the following likely needs and behaviors relevant to corrections settings:

• Probable need for mental health intervention
• Probable need for substance abuse treatment
• Probable need for anger management services
• Reaction to authority
• Escape risk
• Disposition to malinger
• Response to crowding/isolation
• Amenability to treatment/rehabilitation
• Suicidal tendencies

Scoring Options

Hand Scoring

Q™ Local Software - Enables you to score assessments, report results, and store and export data on your computer.

Mail-in Scoring Service - Specially designed answer sheets are mailed to us for processing within 24–48 hours of receipt and returned via regular mail.

Optical Scan Scoring - Allows you to score the assessments at your site.

Questions and Answers

When is it appropriate to use the MCMI-III test?
The MCMI-III test should be used for diagnostic screening or clinical assessment of adults who evidence problematic emotional and interpersonal symptoms or who are undergoing professional psychotherapy or a psychodiagnostic evaluation. It should not be used with nonclinical cases. Individuals under the age of 18 should be administered the Millon Adolescent Clinical Inventory (MACI™ test) or the Millon Pre-Adolescent Clinical Inventory (M-PACI™), depending on the individual’s age, rather than the MCMI-III test.

What are base rate scores?
Base rate scores are a kind of standardized score that differs from the standardized scores that are reported for most personality and clinical inventories. Instead of standardizing all scales in the inventory to the same mean and standard deviation (e.g., a mean of 50 and standard deviation of 10) in the inventory’s normative sample, base rate scores are scaled to reflect the differing prevalence rates of the characteristics measured by the inventory. Base rate scores are unique to the Millon inventories. See the MCMI-III manual for a more complete description of the rationale and implementation of base rate scores.

What is the purpose of the Grossman facet scales?
The facet scales help pinpoint the specific personality processes (e.g., self-image, interpersonal relations) that underlie overall elevations on the Clinical Personality Patterns and Severe Personality Pathology scales, thereby aiding in the interpretation of those scales. For each of the primary personality scales, three scales measuring “facets” specified by Millon’s theory as prominent structural or functional features of that personality pattern are reported. Thus, there are 42 total facet scales tied to the 14 primary personality scales.

How are the Grossman facet scale results reported?
The profile report includes a graph showing the most salient facet scale scores and a table showing all 42 facet scale scores. The interpretive report includes the graph, the table, and a section with interpretive text for the scales. Printing the facet scale results is optional for both the profile report and the interpretive report.

How is the MCMI-III test different from the MCMI-II test?

• Ninety items were revised or replaced.
• One new personality scale (Depressive) was added.
• One new Clinical Syndrome scale (PTSD) was added.
• New Noteworthy Responses sections were added for childhood abuse and eating disorders.
• The Axis I scales, specifically Alcohol Dependence, were improved.
• The item-weighting scheme was changed.
• There are fewer items per scale and less item overlap among scales.

MCMI-III Corrections Report

What is the difference between the MCMI-III Interpretive Report and the MCMI-III Corrections Report?
These reports differ in two major ways. First, the corrections report was normed on a correctional population rather than a psychiatric population. BR (base rate) modifications were made for those Clinical Personality Patterns scales (1—8B) where differences in prevalence were found between correctional inmates and psychiatric patients. (For males, these scales are 1, 2A, 2B, 4, 6B, 7, 8A, and 8B; for females, they are 2A, 3, 4, 6B, 7, and 8A.)

Is the MCMI-III Corrections Report based on empirical data?
Parts of the report are based on empirical data, and parts are based on Dr. Millon's theories and clinical insights. For example, each inmate is classified as "High," "Moderate," or "Low" in terms of his or her probable need for mental health intervention, for substance abuse treatment, and for anger management services. These classifications are based on prediction models developed as part of a large-scale research project involving over 10,000 inmates who completed the MCMI-III test at intake. (This research is described in more detail below.) Other behavioral and clinical predictions and inferences contained in the report, such as an analysis of the inmate’s personality patterns and of treatment considerations, are theoretically driven.

With the high rate of incarceration for blacks and Hispanics, what is the cultural sensitivity of the MCMI-III Corrections Report?
Cultural sensitivity probably isn't an issue, but it can be studied in future research. For example, initial studies indicate that ethnic/cultural background isn't a factor in violent tendencies. (Gang membership was a poor predictor of violence in maximum security prisons.) The MCMI-III Corrections Report helps corrections staff deal with inmates and make the best management decisions regardless of ethnic/cultural background.

What research has been done regarding the usefulness of the MCMI-III Corrections Report in prison systems?
Between 1995 and 1999, approximately 10,000 consecutive inmate admissions to the Colorado Department of Corrections were administered the MCMI-III test as a part of their intake screening. The results of this initial screening were then compared with the "real-world" outcomes obtained from routine management within the correctional system. This comparison produced the following data.

• An inmate with a score of 75 or higher on the Major Depression scale is 950% more likely to be rated a "high risk for psychiatric services" than an inmate with a score of 74 or lower. This same inmate is 790% more likely to be given a psychiatric diagnosis, 740% more likely to be placed on psychotropic medication, and 450% more likely to be a "high user" of mental health time.
  
  
• An inmate with a score of 75 or higher on the Drug Abuse scale is 1,130% more likely to be rated a "high risk for substance abuse services" than an inmate with a score of 74 or lower. This same inmate is 130% more likely to be charged and convicted of a drug-related offense after being in prison.
  
  
• An inmate with a score of 75 or higher on the Antisocial scale is 420% more likely to be rated a "high risk for substance abuse services" than an inmate with a score of 74 or lower. This same inmate is 120% more likely to be charged and convicted of a drug-related offense after being in prison.
  
  
• An inmate with a score of 75 or higher on the Alcohol Abuse scale is 140% more likely to be rated a "high risk for assaultive problems" than an inmate with a score of 74 or lower. This same inmate is 140% more likely to be charged and convicted of an assault after being in prison.

For more information on this study, contact us at 800-627-7271.

Can I receive an interpretive report (not a corrections report) for an examinee in a Correctional Inmate setting?
Yes. When the Correctional Inmate setting is indicated, the clinician can choose to receive either the MCMI-III Interpretive Report or the Corrections Report. If an MCMI-III Interpretive Report is generated for the Correctional Inmate setting, the original psychiatric norms will be used. The only difference between an interpretive report for this setting and one for any other setting is that the examinee is referred to as an "inmate" rather than a "patient." If the corrections report is generated, the correctional norms will be used.

Is there research to support the usefulness of the MCMI-III Corrections Report in prison systems?
In a large-scale study, the MCMI-III test scores of over 10,000 state prison inmates tested at intake were compared to important outcomes obtained from the state’s inmate management system in the areas of mental health, substance abuse, and violence. Scores on many of the individual MCMI-III scales showed strong predictive relationships with outcomes such as intake rating of apparent need for mental health intervention and substance abuse treatment, subsequent prescription of psychotropic medication, and subsequent involvement in psychotherapy.

Further, as mentioned above, three prediction models were developed from the data, each involving a different set of MCMI-III predictor scales. These models are used in the MCMI-III Corrections Report to classify each inmate according to his or her probable need for mental health intervention, substance abuse treatment, and anger management services. The validity of these classifications was demonstrated in a cross-validation sample. For example, the higher the level of need for mental health intervention predicted from the MCMI-III test, the more likely an inmate was (a) to be rated by corrections staff as requiring mental health services, (b) to subsequently be assigned a DSM Axis I diagnosis, (c) to subsequently be prescribed psychotropic medication, and (d) to subsequently be seen by a mental health professional for 15 or more minutes per month. Need for substance abuse treatment and need for anger management services predicted from the MCMI-III models were similarly shown to relate to corrections staff ratings made at intake and to objective outcomes over a follow-up period. Details of this research, as well as tables showing specific results, are provided in the MCMI-III Corrections Report User’s Guide.

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