Evolution of the Millon Clinical Multiaxial Inventory.

Dr. Theodore Millon (1928-2014) was a primary architect for the personality disorders in the DSM-III, a structure that has endured into the DSM-5. His 1969 book, Modern Psychopathology, created an elegant framework into which the well-known personality prototypes could be fitted and understood. His theoretical work soon led into the creation of several psychological inventories, most notably the Millon Clinical Multiaxial Inventory (MCMI). The MCMI, now in preparation for its 4th major edition, has been a very popular instrument among clinicians. This article explores the history of the MCMI's development from its origins, through 2 distinct theoretical phases, and to its current status as the MCMI-IV is finalized.

Neurocognitive function among middle-aged and older Hispanic/Latinos: results from the Hispanic Community Health Study/Study of Latinos.

We sought to examine and describe neurocognitive function among middle-aged and older Hispanic/Latino Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants. We analyzed baseline cross-sectional data from the middle-aged and older (ages 45-74 years old) participants (n = 9,063) to calculate neurocognitive function scores and their correlates. Older age and higher depressive symptoms scores were associated with lower average neurocognitive performance, whereas greater educational attainment and household income were associated with higher neurocognitive performance. Hispanic/Latino heritage groups significantly varied in neurocognitive performances. Some neurocognitive differences between Hispanics/Latinos were maintained after controlling for language preference, education, household income, and depressive symptoms. We found notable differences in neurocognitive scores between Hispanic/Latino heritage groups that were not fully explained by the cultural and socioeconomic correlates examined in this study. Further investigations into plausible biological and environmental factors contributing to the Hispanic/Latino heritage group differences in neurocognitive found in the HCHS/SOL are warranted.

Obstructive sleep apnea and neurocognitive function in a Hispanic/Latino population.

OBJECTIVE: We evaluated the association between obstructive sleep apnea (OSA) and neurocognitive function among community-dwelling Hispanic/Latino individuals in the United States. METHODS: Cross-sectional analysis of the Hispanic Community Health Study/Study of Latinos middle-aged and older adults, aged 45 to 74 years, with neurocognitive test scores at baseline measurements from 2008 to 2011. Neurocognitive scores were measured using the Word Fluency (WF) Test, the Brief-Spanish English Verbal Learning Test (SEVLT), and the Digit Symbol Substitution (DSS) Test. OSA was defined by the apnea-hypopnea index (AHI). Multivariable linear regression models were fit to evaluate relations between OSA and neurocognitive scores. RESULTS: The analysis consisted of 8,059 participants, mean age of 56 years, 55% women, and 41% with less than high school education. The mean AHI was 9.0 (range 0-142; normal AHI <5/h). There was an association between the AHI and all 4 neurocognitive test scores: Brief-SEVLT-sum (ß = -0.022) and -recall (ß = -0.010), WF (ß = -0.023), and DSS (ß = -0.050) at p < 0.01 that was fully attenuated by age. In the fully adjusted regression model, female sex was a moderating factor between the AHI and WF (ß = -0.027, p < 0.10), SVELT-sum (ß = -0.37), SVELT-recall (ß = -0.010), and DSS (ß = -0.061) at p < 0.01. CONCLUSION: OSA was associated with worse neurocognitive function in a representative sample of Hispanic/Latino women in the United States.

Depression, anxiety, antidepressant use, and cardiovascular disease among Hispanic men and women of different national backgrounds: results from the Hispanic Community Health Study/Study of Latinos.

PURPOSE: To describe prevalence and relationships to cardiovascular morbidity of depression, anxiety, and medication use among Hispanic/Latinos of different ethnic backgrounds. METHODS: Cross-sectional analysis of 15,864 men and women aged 18 to 74 years in the population-based Hispanic Community Health Study/Study of Latinos. Depressive and anxiety symptoms were assessed with shortened Center for Epidemiological Studies Depression Scale and Spielberger Trait Anxiety Scale. RESULTS: Prevalence of high depressive symptoms ranged from low of 22.3% (95% confidence interval [CI], 20.4-24.3) to high of 38.0% (95% CI, 35.2-41.0) among those of Mexican or Puerto Rican background, respectively. Adjusted odds ratios for depression rose monotonically with number of cardiovascular disease (CVD) risk factor from 1.46 (95% CI, 1.18-1.75) for those with one risk factors to 4.36 (95% CI, 2.47-7.70) for those with five risk factors. Antidepressant medication was used by 5% with striking differences between those with and without history of CVD (15.4% and 4.6%, respectively) and between insured (8.2%) and uninsured (1.8%). CONCLUSIONS: Among US Hispanics/Latinos, high depression and anxiety symptoms varied nearly twofold by Hispanic background and sex, history of CVD, and increasing number of CVD risk factors. Antidepressant medication use was lower than in the general population, suggesting under treatment especially among those who had no health insurance.

Demographic adjustments for the Spanish version of the WAIS-III.

The Spanish version of the third edition of the Wechsler Adult Intelligence Scale (WAIS-III) by TEA Ediciones is an excellent addition to available instruments for Spanish speakers. The Spanish norms function similarly to US norms for individuals aged 16-35. The norms become increasingly different for individuals 35 and older, seemingly because of the lower levels of formal education of the older Spanish cohorts. Using data from a random half of the Spanish sample, the authors developed regression equations to adjust the scaled scores for individuals with a low level of education. The adjustment is made to the level that would have been expected if the individual had 12 years of education, the median level of education of the US norms. The article includes the methodology and values necessary to make the adjustments. The scaled scores were then adjusted for individuals on the second random half of the Spanish sample and compared to the United States norms. The results showed the adjustments succeed in bringing the Spanish norms closer to the US norms.

Assessing personality and psychopathology after traumatic brain injury with the Millon Clinical Multiaxial Inventory-III.

PURPOSE: Despite the widespread use of objective personality inventories as part of neuropsychological assessments of traumatic brain injury (TBI) patients, little research exists to support the use of these instruments with TBI populations. The purpose of the present study is two-fold: first, to examine the prevalence and extent of personality and psychopathological disturbance in TBI patients compared with a general psychiatric sample and, secondly, to determine whether personality profiles of TBI patients fall within a pathological range relative to normative psychiatric and non-psychiatric populations. METHODS: Age-, gender- and ethnically-matched TBI and psychiatric patients (n = 462) completed the Millon Clinical Multiaxial Inventory-III (MCMI-III). RESULTS: TBI patients had more frequent elevations on histrionic, compulsive and somatoform scales compared with the matched psychiatric sample. Most scales for TBI patients fell outside of the range of the test's normative psychiatric population. CONCLUSIONS: Implications for interpretation of MCMI-III profiles of TBI patients are discussed.

Construct validity of the Bender-Gestalt II: comparison with Wechsler Intelligence Scale for Children-III.

This study investigated the relationships of visuomotor constructs as measured by the Bender-Gestalt II with the subtests of the WISC-III. A factor analysis included the standardized Copy and Recall scores of the Bender-Gestalt II and subtest scores of the WISC-III. The Copy score was predicted to load on measures of visual and spatial thinking and the Recall score on a short-term memory factor. The results of a principal components analysis suggest a four-factor solution with the Bender-Gestalt II Copy score loading on a visual and spatial thinking factor primarily with WISC-III Perceptual Organization subtests. The Recall score loaded on a visual and spatial thinking factor as well as a short-term memory factor with the WISC-III Digit Span subtest. The results suggest the Bender-Gestalt II Copy subtest shared commonality with the visual and spatial tasks given the similarity in the visuomotor demands of each test and was less influenced by processing speed or cultural knowledge than other tests on the visual and spatial thinking factor. Also, results suggest Bender-Gestalt II Recall measures elements of both visual and spatial thinking as well as aspects of short-term memory and memory retrieval. Clinical guidelines for co-administration and underlying processing demands are discussed.

Linking personality disorders and clinical syndromes on the MCMI-III.

We examined the relationship between personality disorders (PDs) and clinical syndromes (CSs) as measured by the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1997) in a large, heterogeneous sample of psychiatric patients (N = 2,366) who completed the instrument as part of routine assessment following presentation for treatment. Using separate sets of base rate (BR) and nonoverlapping scale scores, we factor analyzed the PD and CS scales together and then separately. We correlated results from the latter analyses to determine how trait dimensions were associated with syndrome dimensions. We also studied co-occurrence at the scale level by examining CS score profiles of patients who were grouped according to their highest PD scale elevation > or = BR75. Results for the two score sets were very similar and were consistent with previous research on the MCMI-III and its predecessors that identified 3 underlying dimensions loading both PD and CS scales. Three fourths (76.2%) of the sample had a highest PD scale > or = BR75, and among these, 90% had at least 1 CS scale > or = BR75, whereas 62.4% had 3 or more CS scales above this elevation. Findings underscore the substantial overlap between PDs and CSs along 3 dimensions that resemble Horney's (1945) tripartite interpersonal distinction of moving toward, away, and against, as well as Eysenck's (1994) higher order factors of neuroticism, extraversion, and psychoticism.