External Validation of the MMPI-A-RF with Youth with Mental Health Needs: A Systematic Examination of Symptom-Based Correlates and Interpretive Statements Page: 13
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words, adolescents appear to produce certain scale elevations as a function of their age and not
necessarily actual psychopathology.
As another relevant issue, adolescents consistently endorsed a greater number of items on
the MMPI than adults (Archer, 1984; Fontaine, Archer, Elkins, & Johansen, 2001; Marks,
Seeman, & Haller, 1974). Specifically, adolescents regularly produced higher elevations on F,
Pd, Sc, and Ma scales than either college students (Pancoast & Archer, 1992) or adults (Archer,
1984). Such a stable pattern highlights the pathologizing bias produced by the use of adult norms
with adolescents. Archer (2005) made a striking statement in reference to this point:
It is accurate to state that all samples of adolescents, both from clinical and normal
settings, would be expected to show significant elevations on scales Pd, Sc, and Ma,
regardless of the actual symptom status of these adolescents, simply and solely as a
function of the use of adult norms with adolescents. (p. 259).
The pathologizing tendency towards adolescents has important diagnostic implications in that the
use of the MMPI with adolescents frequently led to overdiagnosis of psychopathology. As a
cogent example, almost one-third (32.5%) of adolescent psychiatric inpatient admissions were
incorrectly diagnosed with psychotic symptoms based on their MMPI profiles scored with adult
norms (Chase, Chaffin, & Morrison, 1975).
As an aside, Fontaine and colleagues (2001) outlined several other possible reasons for
adolescents' unusual MMPI endorsement patterns. One explanation may be related to the reading
level requirement of the instrument, which typically hover around sixth to seventh grade
(Johnson & Bond, 1950; Ward & Ward, 1980). While the MMPI was originally intended for use
with individuals 16 and older, Dahlstrom, Welsh, and Dahlstrom (1972) suggested the MMPI
could be used successfully with children as young as 12, with the caveat that they be intelligent.
Thus, it is possible that certain adolescents do not possess the reading proficiency necessary for
accurate responding on the MMPI. Moreover, Fontaine et al. (2001) argued that developmental13
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Sharf, Allyson J. External Validation of the MMPI-A-RF with Youth with Mental Health Needs: A Systematic Examination of Symptom-Based Correlates and Interpretive Statements, dissertation, August 2019; Denton, Texas. (https://digital.library.unt.edu/ark:/67531/metadc1538766/m1/20/: accessed July 17, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; .